DR. MARK SAMUEL EICHENBAUM (NPI# 1871764977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871764977 |
| Entity Type | Individual |
| Full Name | DR. MARK SAMUEL EICHENBAUM |
| Credential | M.D. |
| Practice Address |
4320 Central Ave Saint Petersburg FL 33711-1141 |
| Practice Telephone | 7273453621 |
| Practice Fax Number | 7273814934 |
| Mailing Telephone | 7273453621 |
| Mailing Fax Number | 7273814934 |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2012-02-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
ME 100677 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
4320 CENTRAL AVE |
| City | SAINT PETERSBURG |
| State | FL |
| Zip Code | 33711-1141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639665110 | Armando Alvarez Gonzalez | Nurse Practitioner | 3404 26th Ave S, St Petersburg, FL 33711 | 2018-07-08 |
| 1508398843 | S&r Cares LLC | Preferred Provider Organization | 4201 4th Avenue South Street, St Petersburg, FL 33711 | 2017-03-28 |
| 1245691062 | Brian Paulson | Counselor | 4024 Central Ave # 1239, Saint Petersburg, FL 33711 | 2016-03-08 |
| 1871966069 | Kelly Jean Plant | Home Health Aide | 3611 3rd Ave South, St Petersburg, FL 33711 | 2015-11-10 |
| 1750784815 | Honor Investments LLC | Community/Behavioral Health | 4750 Dophin Cay Ln S, #508, St Petersburg, FL 33711 | 2014-10-03 |
| 1063771947 | Vincent Ford | Physical Therapy Assistant | 3479 22nd Avenue, St.petersburg, FL 33711 | 2012-05-11 |
| 1568758571 | Ashley Lauren Taliaferro | Physical Therapist | 5042 42nd St S, Saint Petersburg, FL 33711 | 2011-06-28 |
| 1801180187 | Karen Lynn Wilcox | Massage Therapist | 2026 44th Street S, Saint Petersburg, FL 33711 | 2011-06-04 |
| 1881998722 | Martha L Allen | Assisted Living Facility | 1860 46 Street South, St. Petersburg, FL 33711 | 2011-01-07 |
| 1760519052 | Scg Palazzo Operator, LLC | Assisted Living Facility | 3600 34th St South, St Augustine, FL 33711 | 2007-02-27 |
| Find all providers in zip 33711 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750375267 | Vijaya L Cherukuri | Internal Medicine | 218 Pasadena Ave S, Saint Petersburg, FL 33707-1251 | 2005-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087722 | Norma Leticia Goodrich | Internal Medicine | 19265 Nw 252nd St, Okeechobee, FL 34972-6966 | 2020-09-14 |
| 1356811897 | Lake Behavioral Health Management | Internal Medicine | 225 W Canton Ave Ste 600, Winter Park, FL 32789-3181 | 2018-11-27 |
| 1528549490 | Ultra Health Providers of Florida | Internal Medicine | 105 Asterbrooke Dr, Deland, FL 32724 | 2018-08-28 |
| 1710464946 | Baptist Agewell Physicians Inc | Internal Medicine | 1350 13th Ave S Ste 118-a, Jacksonville Beach, FL 32250-3203 | 2018-07-20 |
| 1659891018 | Pocketdoc Physicians Pa | Internal Medicine | 333 Se 2nd Ave Ste 2000, Miami, FL 33131-2185 | 2017-06-26 |
| 1003349549 | On Call Wound Care LLC | Internal Medicine | 12798 Forest Hill Blvd Ste 205b, Wellington, FL 33414-4768 | 2017-04-11 |
| 1154781284 | Verimed Health Group Land O' Lakes, LLC | Internal Medicine | 2638 Narnia Way, Ste 101, Land O Lakes, FL 34638-7231 | 2016-03-02 |
| 1083082895 | Edith Maria Ortega | Internal Medicine | 528 Oceanfront, Neptune Beach, FL 32266 | 2015-09-10 |
| 1881083020 | Arnold Jay Simon, M.d. | Internal Medicine | 3175 S Congress Ave Ste 305, Palm Springs, FL 33461-2562 | 2015-01-12 |
| 1912300575 | Geriatrics and Hospitalists Associates | Internal Medicine | 3255 Cypress Legends Cir Apt 433, Fort Myers, FL 33905-5516 | 2014-09-26 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PETERSBURG |
| Zip Code | 33711 |
Please comment or provide details below to improve the information on DR. MARK SAMUEL EICHENBAUM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.